title: Urinary tract infections owing to ESBL-producing bacteria: microorganisms change--clinical pattern does not.
abstract: OBJECTIVE
  Urinary tract infections (UTIs) caused by extended-spectrum beta lactamase (ESBL)-producing bacteria have become a growing problem worldwide. The aim of this study was to investigate the clinical and radiological findings in patients with community-acquired UTIs owing to ESBL-producing bacteria.
  
  
  METHODS
  Files of the patients that had UTI owing to ESBL-producing bacteria, between January 2008 and December 2009, were retrospectively evaluated.
  
  
  RESULTS
  One hundred and eleven UTI episodes in 94 patients were included. Seventy-five per cent of the patients had recurrent UTIs. Ultrasound, dimercaptosuccinic acid (DMSA) scintigraphy and voiding cystourethrography (VCUG) were found abnormal in 36%, 46% and 31% of the patients, respectively. Overall, 68% of the patients had ≥1 underlying predisposing factor for UTI. Male patients and acute pyelonephritis (APN) episodes were more frequent at small ages. The rate of female patients and cystitis episodes predominated with increasing age. Ultrasound, DMSA scintigraphy, VSUG and UT abnormalities were more frequent in patients with APN, and lower UT disturbances were more frequent in patients with cystitis.
  
  
  CONCLUSIONS
  UTIs owing to ESBL-producing bacteria begin to replace UTIs owing to non-ESBL-producing bacteria. However, the clinical pattern of these infections does not seem to be different. Thus, our aim should be to correct underlying predisposing factors in general in order to prevent infections owing to ESBL-producing bacteria.
authors.affiliation: Department of Pediatric Nephrology, Ankara University School of Medicine, Ankara, Turkey. zbozcakar@yahoo.com
authors.forename: Zeynep Birsin
authors.initials: ZB
authors.lastname: Özçakar
authors.forename: Fatoş
authors.initials: F
authors.lastname: Yalçınkaya
authors.forename: Aslı
authors.initials: A
authors.lastname: Kavaz
authors.forename: Gülsüm
authors.initials: G
authors.lastname: Kadıoğlu
authors.forename: Atilla H
authors.initials: AH
authors.lastname: Elhan
authors.forename: Derya
authors.initials: D
authors.lastname: Aysev
authors.forename: Haluk
authors.initials: H
authors.lastname: Güriz
authors.forename: Mesiha
authors.initials: M
authors.lastname: Ekim
mesh_terms: D002675:Child, Preschool; D017714:Community-Acquired Infections; D004926:Escherichia coli / Q000201:enzymology*; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007709:Klebsiella / Q000201:enzymology*; D007710:Klebsiella Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D001618:beta-Lactamases